Vertebral Column Structure and Function

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Questions and Answers

Which muscle is most likely affected by an injury at the C5 spinal level?

  • Trapezius
  • Serratus anterior
  • Levator scapulae (correct)
  • Rhomboid major

A patient experiencing radiating back pain in the lumbar region most likely has a herniated disc affecting which area?

  • Posterior side of the S1 vertebrae
  • Inferior side of the L5 vertebrae (correct)
  • Anterior side of the L1 vertebrae
  • Superior side of the L3 vertebrae

Damage to the long thoracic nerve would most likely result in what condition?

  • Weakened neck flexion
  • Paralysis of rhomboid muscles
  • Depression of the scapula
  • Winged scapula (correct)

Which of the following movements is NOT primarily associated with the trapezius muscle?

<p>Scapular downward rotation (A)</p>
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Injury to the dorsal scapular nerve would affect which group of muscles?

<p>Rhomboid major, rhomboid minor, and levator scapulae (B)</p>
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What is the primary function of the vertebral column?

<p>To protect the spinal cord and provide musculoskeletal support. (C)</p>
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Which of the following describes the amount of vertebrae that are found in the human body?

<p>33 (A)</p>
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Where does most movement occur in the body and whats the second most mobile joint?

<p>Shoulder, then hip (D)</p>
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What is the primary reason for the size increase in the vertebrae as you descend the spinal column?

<p>To bear the increasing body weight. (C)</p>
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Which of the following curvatures is considered a primary curvature of the vertebral column?

<p>Thoracic (B)</p>
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What is the name given to the surgical procedure used to relieve pressure on the spinal cord and nerves caused by intervertebral disc protrusion?

<p>Laminectomy (D)</p>
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Which part of the vertebrae is located anteriorly?

<p>Vertebral body (A)</p>
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What anatomical structure is characteristically found in cervical vertebrae but not in other types of vertebrae?

<p>Foramen transversarium (D)</p>
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Which structure does the vertebral artery and vein pass through in cervical vertebrae?

<p>Foramen transversarium (D)</p>
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What is a unique characteristic of the atlas (C1) vertebra?

<p>It lacks a vertebral body. (B)</p>
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What is the primary function of the odontoid process (dens) of the axis (C2)?

<p>To provide a point of articulation with the atlas, and enables rotation (C)</p>
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Which type of joint is formed by the articulation between C1 and C2?

<p>Pivot Joint (B)</p>
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What is distinctive about the thoracic vertebrae?

<p>They have a heart-shaped body and coastal facets. (B)</p>
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Which characteristic belongs to lumbar vertebrae?

<p>They have a large vertebral body and mammillary processes. (C)</p>
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The fusion of which structures leads to the median sacral crest?

<p>Spinous processes (C)</p>
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Between which vertebrae are intervertebral disks not present?

<p>C1 and C2 (A)</p>
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What is the main function of the annulus fibrosus in an intervertebral disc?

<p>To provide stability and contain the nucleus pulposus. (C)</p>
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What is the function of the transverse ligament of the atlas?

<p>Hold the dens against the arch of the atlas. (A)</p>
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What is a key characteristic of veins that is not typically found in arteries?

<p>Valves (C)</p>
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What is a unique characteristic of the internal vertebral venous plexus (Batson's plexus)?

<p>It lacks valves, therefore allowing bidirectional blood flow. (B)</p>
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Which layer is directly beneath the subcutaneous fat?

<p>Deep Fascia (D)</p>
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A herniation of the L4/L5 disc would likely compress which spinal nerve root?

<p>L5 (C)</p>
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Damage to posterior rami at T3-T6 would likely result in weakness of which muscle?

<p>Longissimus thoracic (B)</p>
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Flashcards

Vertebral Column

The bony structure that makes up the spine, comprised of 33 individual bones called vertebrae.

Vertebra

A single bone in the vertebral column, with a body, arch, and various processes. There are 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal vertebrae.

Vertebral Canal

The space within the vertebral column through which the spinal cord passes.

Primary Curvature

The primary curve of the spine concave anteriorly, present since embryonic development.

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Secondary Curvature

The secondary curve of the spine concave posteriorly, developing after birth. It includes the cervical and lumbar curvatures.

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Articular Processes

A pair of projections from the vertebrae, which help with articulation and form facet joints.

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Spinous Process

The bony projection at the back of the vertebra, arising from the lamina.

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Vertebral Body

The large, anterior part of a vertebra, which bears weight.

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Long Thoracic Nerve

The Long Thoracic Nerve is responsible for innervating the Serratus Anterior muscle, which helps to protract and rotate the scapula.

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Spinal Accessory Nerve

The Spinal Accessory Nerve innervates the Trapezius muscle, which allows for actions such as scapular retraction, elevation, depression, and upward rotation.

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Dorsal Scapular Nerve

Damage to the Dorsal Scapular Nerve, which innervates the Rhomboid Minor, Rhomboid Major, and Levator Scapulae muscles, can result in difficulty retracting, elevating, and downwards rotating (or depressing) the scapula.

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Winged Scapula

A winged scapula occurs when the Serratus Anterior muscle is weakened or paralyzed, causing the scapula to protrude laterally.

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Vertebral Hyperextension Injury

A vertebral hyperextension injury often involves damage to the anterior longitudinal ligament and intervertebral discs due to excessive backward bending of the spine.

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Atlas (C1)

The first cervical vertebra (C1) is designated as the "atlas" and is characterized by its ring-like appearance, lacking a vertebral body. It supports the skull and allows for nodding movements.

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Axis (C2)

The second cervical vertebra (C2) is known as the "axis" and is the strongest in the cervical region. It features a prominent odontoid process (dens), which acts as a pivot point for rotation of the atlas (C1), enabling head shaking.

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Thoracic Vertebrae

Thoracic vertebrae are characterized by heart-shaped bodies with two costal facets on each side for articulation with ribs. They have smaller, circular vertebral foramina compared to cervical or lumbar vertebrae.

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Lumbar Vertebrae

Lumbar vertebrae are the largest and most robust of the vertebral column. They have large, kidney bean-shaped bodies and prominent processes like the mammillary and accessory processes, providing attachment points for powerful back muscles.

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Sacrum

The sacrum is a triangular bone formed by the fusion of five sacral vertebrae. Features include the median sacral crest, intermediate sacral crest, and lateral sacral crest, formed by the fusion of spinous, articular, and transverse processes, respectively.

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Intervertebral Discs

Fibrocartilage pads found between vertebral bodies that provide cushion, shock absorption, and flexibility to the spine. They consist of an outer annulus fibrosus and an inner nucleus pulposus.

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Posterolateral Disc Protrusion

The most common type of disc protrusion where the nucleus pulposus protrudes posterolaterally, putting pressure on spinal nerve roots.

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Transverse Ligament

A strong ligament located in the cervical region that holds the odontoid process (dens) against the arch of the atlas (C1), ensuring stability and preventing spinal cord injury.

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Internal Vertebral Plexus (Batson's Plexus)

A network of veins within the vertebral canal that drain deoxygenated blood from the spinal cord and vertebral column. It is known as the "Batson's plexus" and lacks valves, allowing for potential spread of tumors or infections.

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Superficial Fascia

A thin layer of connective tissue located beneath the skin, providing protection and supporting blood vessels and nerves.

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Intrinsic Back Muscles

Muscles attached to the vertebral column that contribute to movements like rotation, extension, and flexion of the spine.

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Radicular Pain

Pain radiating along a spinal nerve root caused by compression or irritation, often associated with disc herniation.

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Scoliosis

A condition characterized by lateral curvature of the spine. It's most common in the thoracic region and can lead to postural issues.

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Extrinsic Back Muscles

A group of extrinsic back muscles that are primarily responsible for movements of the scapula (shoulder blade) and arm.

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Longissimus Thoracic Muscle

This muscle is an important extensor of the spine and can be weakened by damage to the posterior rami of spinal nerves in T3-T6 vertebrae.

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Disc Herniation

The process in which the nucleus pulposus of an intervertebral disc protrudes through the annulus fibrosus, potentially causing pressure on nerve roots.

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Study Notes

Vertebral Column Structure and Function

  • The vertebral column forms the musculoskeletal axis of the back, connecting the skull and pelvis to various body parts.
  • There are 33 vertebrae in total: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (fused), and 4 coccygeal (fused).
  • Spinal cord and nerves are protected within the vertebral canal.
  • Joints facilitate movement between vertebrae.
  • Shoulder and hip joints are the most mobile due to ball-and-socket structure.
  • Vertebrae increase in size distally to accommodate increasing weight bearing.
  • Vertebral column exhibits curvatures: primary (thoracic, sacral) present at birth, concave anteriorly; secondary (cervical (3-6 months) , lumbar (1 year)) develop later, concave posteriorly/convex anteriorly.
  • Spinous processes are posteriorly positioned.

Vertebral Anatomy

  • Thoracic vertebrae serve as a representative example.
  • The vertebral body is anterior.
  • Lamina is located between the transverse and spinous processes
  • Pedicle is between the vertebral body and transverse process.
  • Superior and inferior articular processes form facet joints (zygapophyseal joints).
  • Cervical vertebrae have a foramen transversarium (notch) for blood vessels, a smaller body, and larger vertebral foramen; concave superior, convex inferior articular processes.
  • The vertebral artery and vein pass through the foramen transversarium to supply the brain.
  • C1 (atlas) lacks a vertebral body, and forms a ring-like structure.
  • C2 (axis) possesses an odontoid process (dens), crucial for head rotation.
  • Axis (C2) and atlas (C1) form the atlantoaxial joint.
  • Thoracic vertebrae have a heart shape and two costotransverse facets to articulate with ribs
  • Lumbar vertebrae have a large vertebral body and prominent spinous and transverse processes.
  • Sacrum is composed of 5 fused vertebrae, with a median sacral crest formed by fused spinous processes.
  • Sacral foramina allow for the passage of nerves.
  • Sacral cornua are important for anesthetic injections.

Intervertebral Discs and Ligaments

  • Intervertebral discs are absent between C1 and C2, the skull, and the coccyx.
  • There are approximately 23 intervertebral discs in the spine.
  • Intervertebral discs have an annulus fibrosis (fibrocartilage) and nucleus pulposus.
  • Disc herniation (nucleus pulposus protrudes) is common and frequently causes pain.
  • Ligaments limit and control joint movement.
  • Transverse ligament holds the dens against the atlas.

Blood Supply and Nerve Pathways

  • Veins have valves to ensure unidirectional blood flow toward the heart.
  • Internal vertebral venous plexus (Batson's plexus) drains deoxygenated blood; lacks valves.
  • Spinal nerves and vessels pass through the vertebral column.
  • Injury to spinal nerves and processes and ligaments or vessels or nerves impact movement, sensation, and function.

Muscle Function and Innervation

  • Muscles facilitate movement at joints.
  • Extrinsic back muscles include the trapezius, latissimus dorsi, and others; fibers move distal attachment towards proximal.
  • Intrinsic back muscles are responsible for vertebral column functions.
  • Specific muscles have specific actions, determined by fiber orientation and insertion points.
  • Injury to specific spinal nerves affects specific muscle groups and movements.
  • Specific nerves like the dorsal scapular nerve or long thoracic nerve are crucial for the actions of specific muscles like rhomboids or serratus anterior, respectively, impacting shoulder blade movement (winged scapula)

Spinal Injuries and Conditions

  • Disc herniation, fractures, and spinal injuries can cause significant pain, weakness, and other disabling conditions.
  • Scoliosis is a spinal deformity that causes curvature.
  • Damage to spinal nerves can produce pain, weakness, and other symptoms.
  • Compression of specified spinal nerves can lead to symptoms in the legs.
  • Vertebral hyperextension injuries affect the spinal ligaments and intervertebral discs.

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